International Ophthalmology

, Volume 30, Issue 4, pp 397–405 | Cite as

Association between radioiodine therapy for Graves’ hyperthyroidism and thyroid-associated ophthalmopathy

  • Samer El-Kaissi
  • Joanne Bowden
  • Margaret J. Henry
  • Myra Yeo
  • Bernard L. Champion
  • Peter Brotchie
  • Geoffrey C. Nicholson
  • Jack R. Wall
Original Paper


To investigate the role of radioactive iodine (RAI) in the onset and progression of thyroid-associated ophthalmopathy (TAO). Forty-six Graves’ disease patients with mild or no ophthalmopathy were prospectively treated with carbimazole (CBZ) (n = 22) or RAI (n = 24). Treatment effects were evaluated clinically over 12 months, and with orbital MRI-measured extra-ocular muscle (EOM) volumes at baseline and at 6 months. The diagnosis of TAO was based on the clinical activity score (CAS) system. There were 11/22 CBZ and 10/24 RAI patients with active ophthalmopathy at baseline. Despite greater mean TSH levels post-RAI (P = 0.003), there was no increase in the likelihood of developing active ophthalmopathy (OR 0.95; 95% CI 0.56–1.61, P = 0.9) or EOM dysfunction (OR 0.52; 95% CI 0.26–1.06, P = 0.074). The increased mean palpebral aperture post-RAI (P = 0.023) and greater mean proptosis in the CBZ group (P = 0.005) were not confirmed when the absolute values of these measurements were examined. There was no association between the treatment received and MRI-measured EOM volumes. In this study, RAI therapy for Graves’ disease did not increase the risk of progression or development of ophthalmopathy in patients with mild or no eye disease at baseline.


Radioactive iodine Carbimazole Ophthalmopathy Graves’ disease Magnetic resonance imaging 





The National Health and Medical Research Council of Australia.

Conflicts of interest



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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Samer El-Kaissi
    • 1
  • Joanne Bowden
    • 1
  • Margaret J. Henry
    • 1
  • Myra Yeo
    • 1
  • Bernard L. Champion
    • 2
  • Peter Brotchie
    • 3
  • Geoffrey C. Nicholson
    • 1
  • Jack R. Wall
    • 2
  1. 1.Department of Clinical & Biomedical Sciences, Barwon HealthThe University of MelbourneGeelongAustralia
  2. 2.Department of Medicine, Nepean Hospital, Nepean Clinical SchoolThe University of SydneySydneyAustralia
  3. 3.Department of Radiology, Barwon HealthThe Geelong HospitalGeelongAustralia

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